对伴有静脉不对称征的急性脑梗死患者扩容治疗预后的影响

doi:10.3877/cma.j.issn.2095-9133.2018.06.009

目的

探讨伴有静脉不对称征(asymmetry vein sign，AVS)的急性脑梗死患者经扩容治疗后能否改善此部分患者的神经功能预后。

方法

筛选符合入组标准的急性脑梗死患者40例，根据磁共振磁敏感加权成像(susceptibility weighted imaging，SWI)将其分为AVS组与无AVS组，AVS组22例，无AVS组18例，均给予扩容治疗，比较两组入院、出院时NIHSS评分及出院后90 d mRS评分。

结果

AVS组出院时NIHSS评分(4.86±1.89)分，明显低于无AVS组的(6.56±2.68)分，差异有统计学意义(P<0.05)。有AVS组90 d mRS预后良好率为86.36%，无AVS组90 d mRS预后良好率为55.56%，差异有统计学意义(χ²＝4.71，P<0.05)。

结论

对于急性脑梗死患者，若伴有AVS，扩容治疗后较无AVS的患者具有更好的近期和远期神经功能的预后。

关键词: 静脉不对称征, 脑梗死, 预后

Objective

To explore whether the prognosis of neurological function in patients with acute cerebral infarction complicated by asymmetric vein sign (AVS) could be improved after dilation therapy.

Methods

There were forty patients with acute cerebral infarction who met the inclusion criteria. According to susceptibility weighted imaging (SWI), patients who were given hydroxyethyl starch were classified into 2 groups: AVS and non-AVS . There were 22 cases in the AVS group and 18 cases in the non-AVS group. NIHSS scores at admission, discharge and mRS scores at the 90^th day after discharge were collected. The differences of NIHSS at discharge and mRS at the 90^th day after discharge were compared between the two groups.

Results

The NIHSS score (4.86±1.89) of the AVS group after discharge was significantly lower than that in the non-AVS group(6.56±2.68), which showed a significantly statistical difference (P<0.05). The good prognosis rate of mRS at the 90^th day was 86.36% (AVS group) VS 55.56% (non-AVS group) respectively, which showed a significantly statistical difference between AVS and non-AVS group(χ² =4.71, P<0.05).

Conclusion

Patients with acute cerebral infarction who are associated with AVS have better prognosis of short-term and long-term neurological function after dilation than patients without AVS do.

Key words: Asymmetry Vein Sign, stroke, Prognosis

表1 两组一般资料比较

项目	例数	年龄(岁，±s)	男性[例(%)]	高血压[例(%)]	糖尿病[例(%)]	吸烟[例(%)]	LDL-C(mmol/L，±s)	空腹血糖(mmol/L，±s)
无AVS组	18	69.33±11.47	9(50.00)	16(88.89)	5(27.78)	4(22.22)	2.85±0.89	5.66±1.67
AVS组	22	67.68±11.60	12(54.55)	18(81.82)	8(36.36)	6(27.27)	3.00±0.95	5.98±1.5
t/χ值	?	0.45	0.08	0.39	0.33	0.14	0.49	0.64
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

表1 两组一般资料比较

项目	例数	年龄(岁，±s)	男性[例(%)]	高血压[例(%)]	糖尿病[例(%)]	吸烟[例(%)]	LDL-C(mmol/L，±s)	空腹血糖(mmol/L，±s)
无AVS组	18	69.33±11.47	9(50.00)	16(88.89)	5(27.78)	4(22.22)	2.85±0.89	5.66±1.67
AVS组	22	67.68±11.60	12(54.55)	18(81.82)	8(36.36)	6(27.27)	3.00±0.95	5.98±1.5
t/χ值	?	0.45	0.08	0.39	0.33	0.14	0.49	0.64
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

表2 两组NIHSS评分比较(±s)

组别	例数	入院时NIHSS评分	出院时NIHSS评分
无AVS	18	9.11±2.68	6.56±2.68
有AVS	22	8.91±2.00	4.86±1.89
t值	?	0.27	2.26
P值	?	>0.05	0.05

表2 两组NIHSS评分比较(±s)

组别	例数	入院时NIHSS评分	出院时NIHSS评分
无AVS	18	9.11±2.68	6.56±2.68
有AVS	22	8.91±2.00	4.86±1.89
t值	?	0.27	2.26
P值	?	>0.05	0.05

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Effect of blood volume expansion on the Prognosis of Acute Cerebral Infarction with asymmetrical vein sign on SWI

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Effect of blood volume expansion on the Prognosis of Acute Cerebral Infarction with asymmetrical vein sign on SWI